Specialty Lenses · High Prescriptions & Premium Vision · COVE New Albany

Scleral lenses for high prescriptions & premium vision, in New Albany, Ohio.

If you've been told you're too nearsighted, too farsighted, or too astigmatic for contacts, that may be a stock-lens limitation, not the end of the conversation. And if you've been wearing soft contacts for years and want to see sharper, there may be more on the table than you know.

If your prescription is strong enough that off-the-shelf soft contact lenses don't go that high, fit poorly, or don't correct your astigmatism reliably, you may have been told you're "too" something for contacts. There's often a different lens on the table.

Custom scleral lenses can be designed in very high powers, with high cylinder, and with more stable optics than soft contacts typically deliver. Patients with very high prescriptions may see clearer in sclerals than they were able to in glasses or soft contacts.

This page is also for patients who can already see "well enough" and want to see great: pilots, surgeons, photographers, and anyone else whose work or hobby depends on edge-case visual acuity. At COVE, every fit is custom-designed off your specific corneal topography, with two lens platforms we know and trust (Zenlens® and WAVE ScleraLens®), and we don't stop until the fit is right.

Schedule a high-prescription or premium-vision scleral consultation.
01
The Condition

When standard contacts can't deliver.

Off-the-shelf soft contact lens manufacturers stock common prescriptions. Once your prescription leaves the common range, the manufacturers either don't make a lens that strong or only make a small selection in limited base curves. The result is the same regardless of which direction your prescription is extreme:

  • Very high myopia (typically beyond -10 D, sometimes -15 to -20 D and higher): soft contacts may not be available in your power, or they don't fit the eye properly because the lens periphery is too thick.
  • Very high hyperopia (typically beyond +6 to +8 D): similar story. High-plus soft lenses are uncommon and the optical quality often falls short of what glasses deliver, even though glasses themselves cause magnification and edge distortion.
  • Very high astigmatism (typically 4 D of cylinder or more, especially when combined with high sphere): soft toric contacts above 2.75 D of cylinder are limited in availability, and even when they exist, the lens rotation on the eye makes the correction unstable.

If you've ever been told "you're a hard fit" or "we don't make contacts that strong," you've been describing this problem. It's a stock-lens problem, not an eye problem. Custom sclerals are not bound by stock-lens limitations.

02
The Solution

Why scleral lenses deliver superior vision.

A scleral lens is a large, gas-permeable contact lens that vaults entirely over the cornea and rests on the white of the eye. The space between the lens and your cornea is filled with preservative-free saline. Three things make this design ideal for high prescriptions, and for anyone seeking the sharpest possible vision:

Every cornea also has higher-order aberrations: small irregularities in the corneal surface that distort the way light reaches the retina. Coma, trefoil, spherical aberration. They're invisible on a routine refraction but real, and they're a major reason two patients with the same prescription can have meaningfully different vision quality.

i.   Custom power

Custom power, no stock limit

Sclerals are made-to-order, not pulled from a manufacturer's catalog. Whatever prescription your eye actually needs, the lab can design and manufacture: high minus, high plus, high cylinder, and combinations well beyond what stock soft lenses offer.

ii.   Stable optics

Stable optics, even with high cylinder

Soft toric contacts rotate slightly on the eye every time you blink. With low cylinder, the rotation barely matters. With high cylinder, it matters a lot. Sclerals are too large to rotate meaningfully. Your astigmatism correction tends to stay where it was designed to be, blink after blink.

iii.   Smooth surface

A smooth surface that replaces the cornea optically

The saline reservoir under the lens neutralizes the cornea optically. The fluid layer fills in microscopic irregularities; the lens front surface, not your cornea, becomes the optical surface. High-minus glasses minify the world; high-plus glasses magnify it. Sclerals sit on the eye and produce cleaner, edge-to-edge vision without those compromises.

For very high prescriptions, the practical difference is often dramatic. Patients describe seeing the world without the ring scotoma, without the magnified-or-minified feel, without the corner distortion they've lived with for decades.

Many leave their first follow-up reading lines on the chart they didn't know existed.

Cross-section diagram showing how a scleral lens vaults over the cornea and rests on the white of the eye
A scleral lens clears the cornea entirely; its smooth front surface, not your cornea, does the focusing.
03
Indications

Who this is for.

i.   High myopia

Very high myopia

Prescriptions beyond -10 D, sometimes -15 to -20 D or higher. Glasses are heavy and minify the world; soft contacts may not come in your power or fit properly. Sclerals can be designed in extremely high minus powers without sacrificing optical quality.

ii.   High hyperopia

Very high hyperopia

Prescriptions beyond +6 to +8 D. Glasses magnify and distort at the edges; off-the-shelf soft contacts in high plus are uncommon and optically compromised. Custom sclerals deliver clean, stable, edge-to-edge vision in powers other lenses can't match.

iii.   Demanding professions

Visually demanding professions

Pilots, surgeons, photographers, video editors, dentists, professional drivers, marksmen: anyone whose work performance is bottlenecked by visual acuity. Sclerals often outperform soft contacts and glasses in side-by-side comparison.

iv.   "Told no"

"You've been told no"

If you've been told your prescription is too strong for contacts, or that you're "not a candidate," that's a stock-lens conclusion. Custom sclerals are usually a different answer. Worth at least a topography scan and a conversation.

04
Bigger Picture

A note for parents of children with high myopia.

If you're an adult with very high myopia and you have children, their myopia trajectory is worth watching closely.

Heritability and trajectory

High myopia tends to be heritable. The earlier a child's myopia starts and the faster it progresses, the higher their final prescription is likely to be, and high myopia carries lifelong risks (retinal detachment, myopic maculopathy, earlier cataracts, glaucoma) that are absolutely worth slowing.

We can't undo your prescription, but we can change your child's trajectory. Myopia management at COVE uses Ortho-K, MiSight contact lenses, atropine drops, and Stellest spectacle lenses to meaningfully slow childhood myopia progression, so your child doesn't end up where you are.

Wide-field retinal imaging camera at Central Ohio Vision and Eyecare in New Albany, used to monitor the retinal health of patients with high myopia
The risks listed above (retinal detachment, myopic maculopathy) apply to your own eyes too, not just your kids'. We include wide-field retinal imaging in your routine exam to keep watch.
05
Expectations

What to expect on the eye chart.

We're careful with the promises here. Every eye has an anatomical ceiling on how sharply it can ever see, and sclerals don't change that ceiling; they help you reach it.

What we tell patients honestly:

  1. 01
    Many patients gain measurable sharpness or stability in sclerals compared to their best glasses or soft contacts.
  2. 02
    Many see two lines sharper, particularly patients who had been topping out at 20/25 or 20/30 and didn't know why.
  3. 03
    Some see lines they didn't know existed. Patients who have always been "20/20 corrected" sometimes find they can read a bit further down the chart in sclerals.
  4. 04
    Vision stability is the bigger win for many. Even when the chart number doesn't change much, the vision feels different all day: no fluctuation, no end-of-day blur, no shift after a long screen session.

If your eyes are already at their anatomical limit in soft contacts, sclerals may not get you sharper on the chart. We'll tell you that during the consultation, based on the topography and the trial fit, rather than after you've paid for a fit.

06
The Fitting

How the fit process works.

High-prescription sclerals on healthy eyes typically fit predictably. The cornea is regular, and most of the work is in the lens design (getting the power exactly right) rather than in the corneal mechanics. Most fits land in 1–3 lens iterations.

  1. 01
    Routine eye exam plus corneal topography on the Oculus Keratograph 5M. A precise map of your corneal curvature and any subtle irregularities.
  2. 02
    Anterior segment OCT. Cross-sectional imaging that lets us design the lens vault and edge geometry precisely for your eye.
  3. 03
    Lens platform selection. Zenlens® (diagnostic-trial workflow) or WAVE ScleraLens® (built directly from your topography map). For very high cylinder, the WAVE platform's topography-driven design can be especially useful; for premium-vision patients, WAVE can also incorporate higher-order correction directly into the lens design.
  4. 04
    Custom lens design. The lab manufactures to our specifications, including the exact sphere, cylinder, and axis your eye needs.
  5. 05
    Dispense and refinement. Most high-Rx fits take 1–3 lens iterations; premium-vision fits on healthy eyes typically take 1–2. The fitting fee covers all of those revisions; you do not pay per iteration.
Corneal topographer used to map the cornea for a high-prescription scleral lens fitting at COVE in New Albany
Every fit starts with a precise map of your cornea, not a guess off a paper prescription.
No stock limit
custom sclerals are made-to-order in high minus, high plus, and high cylinder
1–3
lens iterations for a typical high-Rx fit, all covered by one fitting fee
12+ hrs
of stable, comfortable wear once the fit settles in
07
The Platforms

Why two lens platforms: Zenlens® and WAVE ScleraLens®.

Most scleral practices fit one lens line. We use both, deliberately, because they're built around fundamentally different design philosophies, and for high-prescription and premium-vision fits, that difference matters.

i.   Diagnostic-trial

Zenlens®: diagnostic-trial workflow

A diagnostic lens from our trial set goes on your eye. We evaluate the fit in real time and refine the order. A strong, fast option for healthy eyes that fit predictably.

ii.   Topography-driven

WAVE ScleraLens®: built from your map

No diagnostic trial. The lens is designed in CAD/CAM software directly from your corneal topography and manufactured to that exact design. WAVE has been doing topography-driven scleral design since 1999. For very high astigmatism, the topography-driven workflow can deliver more accurate cylinder correction than a diagnostic-trial process can, and for premium-vision patients, it can incorporate higher-order correction in ways a stock diagnostic lens can't.

Topography-built scleral design is less commonly offered than the diagnostic-trial workflow most practices use. WAVE has been making lenses this way for more than twenty-five years. Having both platforms in-house lets us pick the right tool for your specific eye.

i.  CUSTOM POWER

Custom power, no stock limit

High minus, high plus, high cylinder, and combinations well beyond what stock soft lenses offer.

ii.  PLATFORMS

Two scleral platforms in-house

Zenlens® and WAVE ScleraLens®.

iii.  INCLUDED

All fitting revisions included

You do not pay per iteration.

08
Wear & Comfort

What it actually feels like.

Day One

First insertion

First insertion is the hardest moment. You're using a small plunger or scleral ring, holding a lens full of saline, tilting your head. We spend as much time as you need teaching this. Once the lens is on, vision usually clears within a minute. The first impression is often "everything is the right size again." For high-prescription patients in particular, the absence of glasses-induced magnification or minification is striking.

Week One

Stable clarity

Insertion takes 30 seconds or less. Comfort holds through 12+ hours of wear without midday discomfort. Vision is stable from morning to night, particularly noticeable for high-astigmatism patients used to soft toric rotation. Most patients report this is when they realize the vision is genuinely different: not just "good," but the kind of clarity that doesn't fade.

Month One

Routine established

Insertion takes seconds. Routine is established. We see you back at the one-week, one-month, three-month, and six-month marks to confirm everything is sitting and seeing the way it should.

09
Cost & Coverage

What scleral lenses cost at COVE.

Pricing depends on whether your specific case qualifies as medically necessary under your insurance. For very high prescriptions, this is often a yes, but coverage rules vary plan to plan. We verify before you commit to anything.

i.   Medical necessity

If documented as medically necessary

Usually covered
when the MNCL benefit applies; the fitting and lenses are billed separately

If your VSP or EyeMed plan includes the Medically Necessary Contact Lens benefit and your case qualifies, your out-of-pocket is usually just a small copay. Coverage rules vary by plan; we verify before your consultation.

ii.   Elective

If elective / not covered

Out of pocket
fitting plus lenses, typically around $1,000 all in

If your plan doesn't include the medically necessary benefit, or your case doesn't meet the threshold, the fit price is the standard healthy-eye scleral fee. This is also the price for premium-vision elective fits.

Insurance and pricing notes
  • Many high-prescription fits qualify for the medically necessary benefit on VSP and EyeMed. The thresholds vary by plan but typically include severe ametropia and high anisometropia (when one eye is significantly different from the other). Call us with your insurance card and we'll verify what we can before the consultation and confirm the rest together at the appointment.
  • All scleral lens costs are FSA and HSA eligible, which is the closest thing to "insurance coverage" available for an elective fit.
  • We recommend annual lens replacement.
10
The Practice

Why patients come to COVE for high-prescription and premium-vision sclerals.

Dr. Matthew Karres has years of clinical experience designing and fitting specialty contact lenses at COVE: scleral, gas-permeable, multifocal, and orthokeratology fits. His research interests within specialty contacts are focused on scleral lens solutions. High-prescription fits depend on lens design precision and a willingness to take the case on, and premium-vision fits live at the intersection of optics and craft. Both are core to how this practice operates.

What that means in practice:

  1. i.
    Topography-driven custom design from day one. Every fit at COVE starts on the Oculus Keratograph 5M and is informed by anterior segment OCT. We don't fit off a paper prescription; we fit off your actual corneal map.
  2. ii.
    Two trusted lens platforms. Zenlens® (diagnostic-trial workflow) and WAVE ScleraLens® (built directly from your topography map). High-cylinder fits often benefit from the WAVE workflow; premium-vision fits benefit from WAVE's ability to incorporate higher-order correction.
  3. iii.
    We don't pass off the hard cases. Patients told elsewhere that they're "uncorrectable in contacts" or "too strong" are usually fittable in custom sclerals. We take the case seriously, map the eye, and tell you honestly what's possible.
  4. iv.
    Honest assessment up front. Some patients are already at their anatomical visual ceiling and won't gain meaningful sharpness from sclerals. We'll tell you that during the consultation rather than after the fitting fee is paid. The patients we fit are the ones who genuinely have headroom to gain.
Dr. Matthew Karres, OD, optometrist at COVE in New Albany, Ohio
Dr. Matthew Karres
Doctor of Optometry, The Ohio State University. Years of clinical experience fitting scleral and specialty lenses, with research interests in scleral lens solutions.
The COVE commitment

Custom high-prescription fits sometimes need extra precision in lens power; refractions in extreme prescriptions are sensitive to small errors. Premium-vision fits require shooting for your best-possible visual acuity, not just acceptable. Either way, when the first lens isn't quite there, we keep iterating at no extra fitting fee until we land it.

What we ask of you: come to your follow-ups, wear the lenses as prescribed, and tell us specifically what's bothering you when something feels off.

Patients who'd been told they were "too strong" for contacts are part of our 1,100+ five-star Google reviews. Reviewers with hard-to-fit prescriptions describe doctors who stay with the fit until it's right, and appointments that don't feel rushed.

“a next level experience”  ·  “very thorough and patient on everything”  ·  “I don’t trust anyone else with my eyes”

Read the reviews for yourself on Google →
11
Questions

Frequently asked questions.

Q.01 I've been told my prescription is too strong for contacts. Is that true? +
Almost never. Off-the-shelf soft contact manufacturers stock common prescriptions, and once your prescription leaves that range, the stock options run out. That's a manufacturer limitation, not an eye limitation. Custom sclerals are made-to-order and can be designed in extremely high minus, high plus, high cylinder, and unusual combinations.
Q.02 Will my insurance pay for this? +
Maybe. Many high-prescription cases qualify for the Medically Necessary Contact Lens benefit on VSP and EyeMed plans. Severe ametropia and high anisometropia are the usual qualifying diagnoses. We verify benefits in advance and work through whether your case qualifies for the medically-necessary or elective pricing path together at the consultation. For premium-vision elective fits on healthy eyes, vision insurance does not cover the elective fitting fee, though your plan's normal contact-lens fitting allowance (a copay or percent discount) often still applies. HSA and FSA funds are eligible for both paths.
Q.03 Will sclerals make my world look "the right size" again? +
Often, yes, and this is one of the most striking changes for high-prescription patients moving from glasses. Glasses minify (high minus) or magnify (high plus) the world; contacts and especially sclerals sit on the eye and don't produce that distortion. Many patients describe it as the room finally being the size they remember from before they needed glasses.
Q.04 I have very high astigmatism. Soft torics never sit right. Will sclerals? +
Yes. Sclerals are too large to rotate meaningfully on the eye, which is the central reason high-cylinder soft torics fail. Every blink rotates the lens slightly, and the cylinder correction misaligns with your eye's astigmatism. Sclerals stay seated. The cylinder correction stays exactly where it was designed.
Q.05 How much sharper will I actually see? +
Honest answer: it depends on where your eyes top out today. Patients who have been topping out at 20/25 or 20/30 in their soft contacts typically gain a line or two. Patients already at 20/15 in soft contacts may gain less on the chart but often gain meaningfully in vision stability and end-of-day comfort. We'll give you a realistic estimate after we look at your topography and do a trial fit, before you commit.
Q.06 I'm presbyopic and I have a high prescription. Are multifocal sclerals an option? +
Yes. We can design multifocal scleral lenses that combine your distance correction with a near add, useful for high-prescription patients who don't want to deal with reading glasses on top of contacts. The fit takes a little more refinement than a single-vision scleral.
Q.07 I'm a pilot or surgeon. Will sclerals hold up all day? +
Yes, and consistency is often the bigger win for surgeons compared to peak chart number. Soft contacts shift slightly with each blink and dry out as the day progresses, both of which can subtly affect vision quality during a long case. Sclerals stay seated, the saline reservoir keeps the surface lubricated, and vision tends to hold steady from your first case to your last.
Q.08 I have kids. Should I be worried about their prescription? +
If your myopia is high and progressed quickly, your kids' myopia is worth following closely. High myopia tends to be heritable, and the earlier childhood myopia starts, the higher the final prescription tends to be. We can slow childhood myopia progression substantially with the right combination of treatments. See our myopia management for kids page.
Q.09 Can I sleep in or swim in scleral lenses? +
No to both. Sclerals are designed for daily wear only. Sleeping in them risks corneal hypoxia. Swimming in them risks contamination from non-sterile water. Take them out at night and don't wear them in pools, lakes, or hot tubs.
Next Step

Schedule a high-prescription or premium-vision consultation.

Whether your prescription has been a barrier to contact lens wear, or you're tired of vision that's "fine" but not what you want it to be, the next step is a corneal topography scan and an honest conversation about what's realistic for your eyes specifically. We can do both at your next routine eye exam.

Related reading: our scleral lens hub  ·  sclerals for keratoconus  ·  sclerals for severe dry eye  ·  sclerals for irregular and post-surgical corneas  ·  myopia management for kids